Effects of an Interactive Handgrip Game on Vascular Maturation and Grip Strength in Patients Undergoing Arteriovenous Fistula Surgery: A Feasibility Randomized Controlled Trial

OBJECTIVES: This study evaluated the effects of an interactive handgrip game on vascular maturation and grip strength in patients undergoing arteriovenous fistula (AVF) surgery. METHODS: This was a preliminary randomized controlled trial. Thirty patients who underwent AVF surgery were randomly assigned to either an interactive handgrip game group or a soft ball group, with 15 participants in each. Both groups began their respective interventions on the first day after returning home; they engaged in either the interactive handgrip game or soft ball exercises for 30 min per session, twice daily (morning and afternoon) for 2 months. Data were obtained using a self-designed structured questionnaire, a Noblus ultrasound machine, and a Jamar hand dynamometer. Assessments were conducted the day before AVF surgery, at the fourth week, and at the eighth week. RESULTS: A total of 30 participants with mean age of 56 years adhered fully to the prescribed training sessions. Compared with the soft ball group, the interactive handgrip game group demonstrated greater improvements in blood flow rate at 8 weeks (1230 vs. 930 mL/min; p < 0.001) and in handgrip strength at both 4 weeks (14 vs. 12 kg; p < 0.001) and 8 weeks (18 vs. 14 kg; p < 0.001). No significant time-by-group interactions were observed for vein diameter or fistula depth. Participants also reported high satisfaction (scores 4.6-5) and strong agreement on the feasibility of the interactive handgrip game (mean = 5). CONCLUSION: A 2-month regimen of an interactive handgrip game yielded significantly greater vascular maturation and grip strength relative to soft ball exercises. In addition, the game resulted in high patient satisfaction and was feasible to implement, supporting its potential as an effective intervention for AVF maturation. TRIAL REGISTRATION: ClinicalTrials.gov: NCT05493046.